Provider Demographics
NPI:1902077795
Name:ULTIMATE HEALTHLINK INC,.
Entity Type:Organization
Organization Name:ULTIMATE HEALTHLINK INC,.
Other - Org Name:GRACIOUS HEALTH LINK INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:ADMINISTRATOR/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:AGONOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN/CNS
Authorized Official - Phone:517-410-4331
Mailing Address - Street 1:720 N SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48906-5055
Mailing Address - Country:US
Mailing Address - Phone:517-485-4855
Mailing Address - Fax:517-485-3988
Practice Address - Street 1:720 N SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48906-5055
Practice Address - Country:US
Practice Address - Phone:517-485-4855
Practice Address - Fax:517-485-3988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2009-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health